不同剂量硼替佐米联合化疗治疗多发性骨髓瘤效果观察
Efficacy observation of different doses of bortezomib combined with chemotherapy for multiple myeloma
高媛 1董鹏 1易亭伍 1林欢 1刘乐佳 1王妍宇 1王爱鑫 1黄丹 1田静1
作者信息
- 1. 乐山市人民医院肿瘤血液科,乐山 614003
- 折叠
摘要
目的 探讨不同剂量硼替佐米联合化疗治疗多发性骨髓瘤(MM)的效果.方法 前瞻性病例系列研究,选取2022年2月至2023年5月乐山市人民医院收治的81例MM患者作为研究对象,按照随机数字表法将患者分成高剂量硼替佐米组(采用硼替佐米1.6 mg/m2联合地塞米松及沙利度胺治疗,39例)和低剂量硼替佐米组(采用硼替佐米1.3 mg/m2联合地塞米松及沙利度胺治疗,42例).比较两组患者治疗4个疗程后临床疗效、不良反应发生情况、治疗前后C反应蛋白、β2-微球蛋白和血肌酐水平及生存预后.结果 高剂量硼替佐米组男性29例,女性10例,年龄(59±5)岁;低剂量硼替佐米组男性31例,女性11例,年龄(59±6)岁.两组基线资料比较,差异均无统计学意义(均P＞0.05).高剂量硼替佐米组与低剂量硼替佐米组总有效率分别为87.2％(34/39)、80.9％(34/42),差异无统计学意义(x2=0.58,P=0.446);高剂量硼替佐米组与低剂量硼替佐米组不良反应发生率分别为30.8％(12/39)、19.0％(8/39),差异无统计学意义(x2=1.49,P=0.222);治疗前两组C反应蛋白、β2-微球蛋白及血肌酐水平比较,差异均无统计学意义(均P＞0.05);治疗后高剂量硼替佐米组与低剂量硼替佐米组的C反应蛋白[(23.6±2.2)g/L 比(31.5±3.6)g/L]、β2-微球蛋白[(2 317±63)μg/L 比(4 212±114)µg/L]及血肌酐[(70±5)µmol/L比(79±7)μmol/L]水平比较,差异均有统计学意义(t值分别为4.28、1 8.29、4.00,均P＜0.05),且两组治疗后3项指标水平均较治疗前低(均P＜0.05).治疗后随访 1年,高剂量硼替佐米组与低剂量硼替佐米组的病死率分别为10.3％(4/39)、14.3％(6/42),差异无统计学意义(x2=0.30,P=0.582).结论 高剂量硼替佐米联合化疗治疗MM疗效及安全性与低剂量硼替佐米联合化疗相当,但可有效改善MM患者的肾功能及炎症状态.
Abstract
Objective To investigate the efficacy of different doses of bortezomib combined with chemotherapy for multiple myeloma(MM).Methods A prospective case series study was performed.A total of 81 MM patients at Leshan People's Hospital from February 2022 to May 2023 were collected as study subjects.According to the random number table method,patients were divided into high-dose bortezomib group(39 cases treated with 1.6 mg/m2 bortezomib combined with dexamethasone and thalidomide)and low-dose bortezomib group(42 cases treated with 1.3 mg/m2 bortezomib combined with dexamethasone and thalidomide).The clinical efficacy after 4 courses of treatment,adverse reactions,C-reactive protein(CRP),β2 microglobulin(β2-MG)and serum creatinine levels before and after treatment,survival and prognosis of patients in both groups were compared.Results There were 29 males and 10 females in the high-dose bortezomib group and the age was(59±5)years;there were 31 males and 11 females in the low-dose bortezomib group and the age was(59±6)years.The differences in the general data of both groups were statistically significant(all P＞0.05).The overall effectiveness rate was 87.2％(34/39)and 80.9％(34/42),respectively in the high-dose bortezomib group and the low-dose bortezomib group,and the difference was not statistically significant of both groups(x2=0.58,P=0.446).The incidence rate of adverse reactions was 30.8％(12/39),19.0％(8/39),respectively in the high-dose bortezomib group and the low-dose bortezomib group,and the difference was not statistically significant of both groups(x2=1.49,P=0.222).Before treatment,there were no statistically significant differences in the levels of CRP,β2-MG and serum creatinine between the 2 groups(all P＞0.05);after treatment,there were statistically significant differences in the levels of CRP[(23.6±2.2)g/L vs.(31.5±3.6)g/L)],β2-MG[(2 317±63)μg/L vs.(4 212±114)μg/L]and serum creatinine[(70±5)μmol/L vs.(79±7)μmol/L]in the high-dose bortezomib group and the low-dose bortezomib group(t value was 4.28,18.29,4.00,all P＜0.05);and the levels of above 3 indicators after treatment were lower than those before treatment of both groups(all P＜0.05).The mortality rate was 10.3％(4/39)and 14.3％(6/42),respectively in the high-dose bortezomib group and the low-dose bortezomib group 1-year follow-up after treatment,and the difference was not statistically significant(x2=0.30,P=0.582).Conclusions The efficacy and safety of high-dose bortezomib combined with chemotherapy are comparable to those of low-dose bortezomib combined with chemotherapy in treatment of MM,while the former could improve renal function and inflammatory status of MM patients.
关键词
多发性骨髓瘤/硼替佐米/药物疗法,联合/预后Key words
Multiple myeloma/Bortezomib/Drug therapy,combination/Prognosis引用本文复制引用
基金项目
四川省科普培训项目(2022JDKP0038)
出版年
2024
NETL
NSTL
万方数据